摘要
目的分析老年肺癌立体定向放射治疗发生≥Ⅱ级放射性肺炎的危险因素。方法 2004年8月至2012年8月我院收治的老年肺癌患者中,随机抽取30例发生≥Ⅱ级放射性肺炎的患者,同时随机抽取未发生放射性肺炎的30例作为对照组。对患者的性别、年龄、体力状况评分(KPS)、病理类型、计划靶区体积(PTV)、肺体积、照射等效生物剂量、合并慢性肺部疾病、吸烟史、化疗史、抗生素治疗史、高血压、糖尿病、冠心病、靶区包括纵隔或肺门淋巴结、肺V20、肺V30、肺癌分型、临床分期等因素进行卡方检验单因素分析及Logistic多因素分析。结果单因素分析显示PTV、等效生物剂量、吸烟史、化疗史、糖尿病、肺V20、肺V30和临床分期是发生放射性肺炎的危险因素;Logistic逐步回归分析显示PTV、吸烟史和化疗史是发生放射性肺炎的独立危险因素(P=0.013,0.013,0.006)。预测分类图显示病例和对照完全分开,能够较准确预测≥Ⅱ级放射性肺炎的发生。结论 PTV大、吸烟史和化疗史增加老年肺癌立体定向放射治疗发生≥Ⅱ级放射性肺炎的风险,临床工作中应给予个体化方案以降低放射性肺炎的发生。
Objective To analyze the risk factors of ≥ grade Ⅱ radiation pneumonitis induced by stereotactic radio- therapy for elderly patients with lung cancer. Methods In the elderly patients with lung cancer in our hospital from Au- gust 2004 to August 2012, 30 patients with ≥ grade Ⅱ pneumonitis were randomly selected as the observation group, and 30 cases without pneumonitis as the control group. The data of sex, age, KPS score, pathological type, planning target vo- lume（PTV）, lung volume, irradiation equivalent biological dose, chronic lung disease, smoking history, chemotherapy history, antibiotic treatment history, hypertension, diabetes, coronary heart disease, target including mediastinal or lung hilar lymph nodes, lung V20, lung V30, lung cancer type and clinical stage were analyzed by X2 test for univariate analysis and Logistic regression test for multivariate analysis. Results Univariate analysis showed that PTV, equivalent biological dose, smoking history, chemotherapy history, diabetes, lung V20, V30 and clinical stage were the risk factors of ≥ grade Ⅱ pneumonitis. Logistic regression analysis showed that PTV （P= 0. 013 ）, smoking history （P= 0. 013 ） and chemotherapy history（ P= 0. 006） were the independent risk factors of radiation pneumonitis. Predicted classification map showed that the observation group was fully separated from the control group. The risk factors could accurately predict the occurrence of ≥ grade Ⅱ pneumonitis. Conclusions Lager PTV, smoking history and chemotherapy history increase the risk of ≥ grade Ⅱ radiation pneumonitis induced by stereotactic radiotherapy for elderly patients with lung cancer.
出处
《实用老年医学》
CAS
2014年第4期302-305,共4页
Practical Geriatrics
